An evaluation of the impact of advanced nurse practitioner triage and clinical intervention for medically expected patients referred to an acute National Health Service hospital.

AIMS AND OBJECTIVES

To evaluate the impact of advanced nurse practitioner triage on the management of medically expected patients referred to an acute National Health Service hospital. The objectives of the study were to determine whether advanced nurse practitioner triage reduced waiting times and hospital admissions and expedited essential investigations and treatments.

BACKGROUND

The effectiveness of employing advanced nurse practitioners to meet service demands has been widely studied in emergency departments and critical care units. However, no studies have evaluated the impact advanced nurse practitioners can have on the management of medically expected patients, who have been referred to hospital because they are acutely unwell and require immediate medical intervention.

DESIGN

A pre- and postimplementation evaluation.

METHOD

The Revised Standards for Quality Improvement Reporting Excellence guidelines were used as a framework to guide the triaging role of advanced nurse practitioners. The charts of patients attending before and after the implementation of the advanced nurse practitioner triage role were retrospectively analysed.

RESULTS

The implementation of advanced nurse practitioner triage for medically expected patients saw a statistically significant reduction in the length of time patients have to wait to be seen. There were also significant improvements in timings to diagnosis and treatment of patients presenting with conditions such as sepsis or community-acquired pneumonia. Additionally, patient admissions to hospital were reduced, as advanced nurse practitioners instead streamed a number of patients to ambulatory care for same day treatment and/or medical follow-up.

CONCLUSIONS

Advanced nurse practitioner triage has made significant improvements to the efficiency and effectiveness of care and management of medically expected patients who were referred to acute hospital settings.

RELEVANCE TO PRACTICE

Utilisation of advanced nurse practitioner triage in the ambulatory care setting is an effective method by which to streamline and improve the management of medically expected patients.